Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patie...Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patients'blood pressure,they were divided into Group A,Group B and Group C,and all the data of hypertension patients in this study were collected,including age,gender,BMI,smoking,drinking,basic diseases(diabetes,cerebrovascular disease,hyperlipidemia,etc.),fasting blood glucose,ambulatory blood pressure(24-hour mean systolic pressure,24-hour mean diastolic pressure,daytime mean systolic pressure and daytime mean diastolic pressure).Results:There were significant differences in mean systolic blood pressure and mean diastolic blood pressure at night among Group A,Group B and Group C(P<0.05).Age,hyperlipidemia and fasting blood glucose were risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium was a protective factor for circadian rhythm abnormality(P<0.05).Conclusion:Age,hyperlipidemia and fasting blood glucose are risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium is a protective factor for circadian rhythm abnormality(P<0.05).展开更多
Introduction: In Guinea, there is few data on dietary practices socio-economic and clinical characteristics of elderly diabetics and hypertensives. Methods: This was a descriptive cross-sectional study of people aged ...Introduction: In Guinea, there is few data on dietary practices socio-economic and clinical characteristics of elderly diabetics and hypertensives. Methods: This was a descriptive cross-sectional study of people aged 60 years and over, seen in consultation or hospitalised in Conakry University hospitals during the period from 5 September to 15 December 2023 inclusively. Results: Among the 320 subjects included in the study, there were more men (50.6%). The average age was 67 ± 7.69 years;53.43% had hypertension and 46.57% had diabetes. Sex was significantly associated with diabetes (p = 0.035). Women in the study were more affected by diabetes (55.7%), 64.4% of diabetic subjects were married and more than 64% of them had dependent children. 26.2% of diabetics were not employed;85.9% had an income;34.9% had an income of less than one million Guinean francs per month and 74.5% of them had 3 meals a day. Physical activity, 24-hour recall for lunch (p Conclusion: Effective management of diabetes and hypertension in the elderly should necessarily involve nutrition education in hospitals.展开更多
Objective:To explore the effects of health education and chronic disease management nursing in elderly community patients with hypertension,in order to provide scientific evidence for improving the health management l...Objective:To explore the effects of health education and chronic disease management nursing in elderly community patients with hypertension,in order to provide scientific evidence for improving the health management level of these patients.Methods:Sixty-four elderly hypertension patients treated at this hospital between March 2022 and March 2024 were selected and randomly divided into two groups,with 32 patients in each group.One group received conventional management,designated as the control group,while the other group received a combined management strategy involving health education and chronic disease management,designated as the experimental group.The study compared the management outcomes of the two groups to evaluate the value of the combined management approach in elderly hypertensive patients in the community.Results:The study found that the experimental group showed significantly lower systolic blood pressure(SBP),diastolic blood pressure(DBP),and scores on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)compared to the control group,with statistically significant differences(P<0.05).Additionally,the experimental group demonstrated significantly higher scores in disease cognition levels regarding awareness of normal blood pressure ranges,prevention of complications,identification of high-risk factors,and healthy lifestyle practices,with statistically significant differences(P<0.05).Moreover,the experimental group showed significantly better rates of self-management behaviors,such as quitting smoking and alcohol,self-monitoring of blood pressure,dietary control,regular medication adherence,and consistent exercise,compared to the control group,with statistically significant differences(P<0.05).Conclusion:This study indicates that a combined management model integrating health education and chronic disease management effectively improves the emotional state of elderly hypertensive patients in the community,significantly enhances their disease cognition levels,and boosts their self-management abilities.Furthermore,this model can effectively lower patients’blood pressure,thereby achieving better health management outcomes for elderly hypertensive patients in the community.展开更多
Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hyp...Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.展开更多
The elderly are the most rapidly growing population group in the world.Data collected over a 30-year period have demonstrated the increasing prevalence of hypertension with age.The risk of coronary artery disease,stro...The elderly are the most rapidly growing population group in the world.Data collected over a 30-year period have demonstrated the increasing prevalence of hypertension with age.The risk of coronary artery disease,stroke,congestive heart disease,chronic kidney insufficiency and dementia is also increased in this subgroup of hypertensives.Hypertension in the elderly patients represents a management dilemma to cardiovascular specialists and other practioners.During the last years and before the findings of the Systolic Hypertension in Europe Trial were published,the general medical opinion considered not to decrease blood pressure values similarly to other younger patients,in order to avoid possible ischemic events and poor oxygenation of the organs(brain,heart,kidney).The aim of this review article is to highlight the importance of treating hypertension in aged population in order to improve their quality of life and lower the incidence of the cardiovascular complications.展开更多
Background Little is known about the prevalence oforthostatic hypertension （OHT） and its effect on long-term mortality in the eld- erly. We evaluated the prevalence of OHT and its effect on mortality in hospitalized...Background Little is known about the prevalence oforthostatic hypertension （OHT） and its effect on long-term mortality in the eld- erly. We evaluated the prevalence of OHT and its effect on mortality in hospitalized elderly patients. Methods Out of 1852 patients admit- ted between 31/12/1999 and 31/12/2000 to an acute geriatric ward, 474 patients （48% males） with a mean age of 81.5 ±6.8 years were en- rolled in this study. Blood pressure （BP） was measured three times during the day in a supine and standing position. Patients with at least one increase in systolic or diastolic BP levels upon standing were diagnosed with OHT. Medical history, physical examination and laboratory parameters were retrieved from the medical records. Mortality data until 18th June 2014 were retrieved from the computerized system of the Ministry of the Interior. Results Four hundred and seven patients （86%） were diagnosed with OHT. Those without OHT had a lowerbody mass index and were more likely males, smokers, had a higher rate of Parkinson＇s disease and less congestive heart failure compared with those with OHT. Patients with OHT had a better survival rate than those without OHT （P = 0.024）. Hazard ratios （HRs） for mortality in those with OHT adjusted to age and multiple risk factors were： 0.67 [95% confidence interval （CI）： 0.51-0.87] and 0.73 （95% CI： 0.55-0.97）, respectively; a similar tendency was noticed in a sensitivity analysis by gender. Conclusion Hospitalized elderly patients with OHT had a better survival rate than those without OHT.展开更多
AIM:To present a dedicated series of transjugular intrahepatic porto-systemic shunts(TIPS) in the elderly since data is sparse on this population group.METHODS:A retrospective review was performed of patients at least...AIM:To present a dedicated series of transjugular intrahepatic porto-systemic shunts(TIPS) in the elderly since data is sparse on this population group.METHODS:A retrospective review was performed of patients at least 65 years of age who underwent TIPS at our institutions between 1997 and 2010.Twentyfive patients were referred for TIPS.We deemed that 2 patients were not considered appropriate candidates due to their markedly advanced liver disease.Of the 23 patients suitable for TIPS,the indications for TIPS placement was portal hypertension complicated by refractory ascites alone(n = 9),hepatic hydrothorax alone(n = 2),refractory ascites and hydrothorax(n = 1),gastrointestinal bleeding alone(n = 8),gastrointestinal bleeding and ascites(n = 3).RESULTS:Of these 23 attempted TIPS procedure patients,21 patients had technically successful TIPS procedures.A total of 29 out of 32 TIPS procedures including revisions were successful in 21 patients with a mean age of 72.1 years(range 65-82 years).Three of the procedures were unsuccessful attempts at TIPS and 8 procedures were successful revisions of our existing TIPS.Sixteen of 21 patients who underwent successful TIPS(excluding 5 patients lost to follow-up) were followed for a mean of 14.7 mo.Ascites and/or hydrothorax was controlled following technically successful procedures in 12 of 13 patients.Bleeding was controlled following technically successful procedures in 10 out of 11 patients.CONCLUSION:We have demonstrated that TIPS is an effective procedure to control refractory complications of portal hypertension in elderly patients.展开更多
Backgrounds Pulmonary arterial hypertension （PAH） was previously considered an illness that affects mostly the young, but now it is also increasingly recognized in the elderly. The aim of this study was to compare t...Backgrounds Pulmonary arterial hypertension （PAH） was previously considered an illness that affects mostly the young, but now it is also increasingly recognized in the elderly. The aim of this study was to compare the features of elderly versus younger patients diagnosed with PAH, and to define the prognostic factors which affect their long-term survival. Methods In this prospective, single center study, the clinical, echocardiographic, hemodynamic characteristics, and the outcomes of younger （18-65 years） and elderly （〉 65 years） patients with definitive diagnosis of precapillary PAIl were compared. Results A total of 119 patients were analyzed in this study; 43 were elderly （mean age： 71.5 ± 5.5 years）, while 76 were non-elderly （mean age 44.5 ±15.2 years）. During the mean follow-up duration of 26.8 ±25.0 months, 43 deaths occurred, 17 of which were among the elderly group, with 28 among non-elderly group. Comparison of baseline parameters showed that 6 min walking distance, hemoglobin levels, pulmonary artery pressures and pulmonary vascular resistance were significantly lower; and estimated glomerular filtration rate, body mass index, E/e＇ and pulmonary capillary wedge pressure were significantly higher in the elderly group than in the younger group. Survival analysis demonstrated that the independent predictors of death were tricuspid plane annular systolic excursion （TAPSE; HR： 1.272, 95% CI： 1.079-1.499, P = 0.004） and uric acid （HR： 1.291, 95% CI： 1.042-1.600, P = 0.019） in the elderly group. In contrast, in the non-elderly group, higher brain natriuretic peptide （HR： 1.002, 95% CI： 1.001-1.004, P 〈 0.001） and higher right atrial pressure （HR： 1.128, 95% CI： 1.026-1.241, P = 0.013） values were the only parameters associated with mortality. Conclusions Our data suggest that elderly PAH patients have a unique clinical and hemodynamic profile, with totally different prognostic markers compared to younger PAH patients.展开更多
Objective The aim of the study is to investigate the effects of psychosocial factors on the treatment of elderly patients with hypertension. Methods Atotalof 260 elderly Chinese patients with hypertension were treated...Objective The aim of the study is to investigate the effects of psychosocial factors on the treatment of elderly patients with hypertension. Methods Atotalof 260 elderly Chinese patients with hypertension were treated with benazepril alone or benazepril combined with amlodipine for 8 weeks. The target blood pressure (BP) (both <140 mmHg systolic, SBP, and <90 mmHg diastolic, DBP) was achieved in 180 patients, who were then assigned to the well-controlled BP group;the rest were placed in the modestly controlled BP group. The psychosocial factors present in both groups were assessed by the Hamilton depression scale, Hamilton anxiety scale, life event scale and social support evaluation list before and after anti-hypertensive treatment. Results There were no significant differences in gender, mean age, hist ory of hypertension, education and smoking habit, or in SBP and DBP between the groups before treatment. Significant differences were also not found in all psychosocial factors before and after treatment in the patients. However, significant differences were found between the groups with respect to post-treatment SBP and marital status. The patients with modestly controlled BP had significantly higher scores, as well as incidents, on the depressive, anxiety, and stressful life event scales than those with well-controlled BP. The patients with well-controlled BP had significantly higher scores in tangible support, subjective support, and social support compared to the patients with modestly controlled BP. Logistic regression analysis showed the independent contribution of psychosocial factors in reaching the goal of lowering BP at treatment endpoint in these hypertensive patients. Conclusions The results suggest that psychosocial factors stand as a main barrier to achieving the BP-lowering target in the management of elderly Chinese patients with hypertension.(J Geriatr Cardiol 2007;4:202-207.)展开更多
Hypertension is one of the most important risk factors for heart diseases today. The effect of hypertension in the elderly is higher than other age groups and it may lead to changes in their quality of life. By the in...Hypertension is one of the most important risk factors for heart diseases today. The effect of hypertension in the elderly is higher than other age groups and it may lead to changes in their quality of life. By the increase of age, the amount of self-care behaviors of patients with hypertension decreased. Therefore, control and self-care behaviors are so important. This study has been conducted to study self-regulation behaviors and Associated Factors in elderly patients with hypertension. This study was a cross sectional, descriptive analytic study, which was conducted using multistage sampling on the elderly 60 years and above with hypertension. The sample size was calculated 365 and the final sample size of 380 people was considered by possible losses. The instruments include of demographic and self-regulatory behaviors questionnaire. The results showed that self-regulation of behavior was 42.3% of the total score. In terms of quality, only 7.4% of the elderly had good behavior, 46.6% of poor performance, and the rest were mediocre performance. Age (p = 0.03), gender (p = 0.02), education (p = 0.001), income level (p = 0.03) and marital status (p = 0.001) significantly associated with behaviors of self-regulation. The results generally indicate unfavorable self-regulation of elderly patients with hypertension. Some variables such as gender, age, marital status, education and income levels were associated with these behaviors. So paying attention to the education of the elderly in care centers is essential.展开更多
In recent times, the prevalence of pulmonary arterial hypertension creased prevalence of hypertension, diabetes, obesity, arterial stiffness, （PAH） is more commonly seen among elderly populations. The inas well as d...In recent times, the prevalence of pulmonary arterial hypertension creased prevalence of hypertension, diabetes, obesity, arterial stiffness, （PAH） is more commonly seen among elderly populations. The inas well as diastolic dysfunction, may cause endothelial dysfunction and affect pulmonary vasculature. Furthermore, older patients have certain differences in clinical characteristics and outcomes. In this article the special characteristics of aging in PAH patients have been reviewed, while the risk predictors of elderly patients are also discussed.展开更多
Objective To compare knowledge about hypertension between elderly Chinese urban patients with preferences for either traditional Chinese medicine (TCM) or Western medicine (WM). Methods Elderly (≥ 65 years old) patie...Objective To compare knowledge about hypertension between elderly Chinese urban patients with preferences for either traditional Chinese medicine (TCM) or Western medicine (WM). Methods Elderly (≥ 65 years old) patients with hypertension who prefer TCM treatment (n=112) or WM (n=126) were questioned about hypertension. Their answers were compared. Results Only 32.6% of participants correctly identified hypertension as a main risk factor of coronary heart disease and stroke, 22.3% of patients answered that the main purpose of hypertension control was preventing cardiovascular disease. Other major reasons for these patients to seek medical treatment for their hypertension included: persuasion by physicians or their family members (21.6%), alleviating symptoms such as headache and dizziness (16.8%), lowering blood pressure without knowing specific reason (12.4%). The predictors for poor knowledge of hypertension were similar irrespective of preference for WM or TCM treatment, and included those with lower levels of education and older age. Television and newspaper (46.8%) were the most frequent sources of hypertension information for both groups. Among those who preferred TCM treatment, "TCM has fewer side effects than WM" and"TCM cures disease while WM only alleviates symptoms" were common beliefs held. Conclusion This study shows that knowledge of hypertension is similar among Chinese urban patients with preferences for either WM or TCM treatment and that misunderstandings about hypertension are common among the elderly patients. In order to control hypertension effectively, public health education is necessary. This should target those with a lower level of education and older age.展开更多
Recent reports from pulmonary arterial hypertension （PAH） registries suggest that the mean age at diagnosis is increasing in a growing proportion of elderly patients. The combination of several reasons such as aging...Recent reports from pulmonary arterial hypertension （PAH） registries suggest that the mean age at diagnosis is increasing in a growing proportion of elderly patients. The combination of several reasons such as aging popula- tion, increase in life expectancy, growing PAH awareness of physicians and patients, and availability of more treatment options could explain the changing picture of PAH. PAH should be considered as an emerging entity in the elderly.展开更多
Background Elevated resting heart rate and hypertension independently increase the risk of mortality. However, their combined ef- fect on mortality in stages of hypertension according to updated clinical guidelines am...Background Elevated resting heart rate and hypertension independently increase the risk of mortality. However, their combined ef- fect on mortality in stages of hypertension according to updated clinical guidelines among dderly population is unclear. Methods We fol- lowed a cohort of 6100 residents （2600 males and 3500 females） of Kangwha County, Korea, ranging from 55 to 99 year-olds as of March 1985, for all-cause and cardiovascular mortality for 20.8 years until December 31, 2005. Mortality data were collected through telephone calls and visits （to 1991）, and were confirmed by death record matching with the National Statistical Office （1992-2005）. Hazard ratios were calculated for all-cause and cardiovascular mortality by resting heart rate and hypertension defined by Eighth Joint National Committee crite- ria using the Cox proportional hazard model after controlling for confounding factors. Results The hazard ratios associated with resting heart rate 〉 80 beats/min were higher in hypertensive men compared with normotensives with heart rate of 61-79 beats/rain, with hazard ratios values of 1.43 （95% CI： 1.00-1.92） on all-cause mortality for prehypertension, 3.01 （95% CI： 1.07-8.28） on cardiovascular mortality for prehypertension, and 8.34 （95% CI： 2.52-28.19） for stage 2 hypertension. Increased risk （HR： 3.54, 95% CI： 1.16-9.21） was observed among those with both a resting heart rate 〉 80 beats/rain and prehypertension on cardiovascular mortality in women. Conclusions Indi- viduals with coexisting elevated resting heart rate and hypertension, even in prehypertension, have a greater risk for all-cause and cardiovas- cular mortality compared to those with elevated resting heart rate or hypertension alone. These findings suggest that elevated resting heart rate should not be regarded as a less serious risk factor in elderly hypertensive patients.展开更多
Background:An elderly was closed to some medical problem,especially hypertension.Problems that occur in elderly patients with hypertension not only involve the patient itself but also involve the family as the closest...Background:An elderly was closed to some medical problem,especially hypertension.Problems that occur in elderly patients with hypertension not only involve the patient itself but also involve the family as the closest person to the patient.One important aspect of family nursing is the family itself.To achieve good treatment outcomes,implementation of evidence-based nursing is needed.The purpose of this study is to present the implementation of evidence-based nursing to an eldelry in a family bu using coconut water to reduce high blood pressure and progressive muscle relaxation therapy to reduce pain intensity in hypertensive patients,as well as acupressure therapy in stopping smoking that is applied 1 week each other.Method:In the implementation,complementary therapy is applied to hypertensive patients by given young coconut water and progressive muscle relaxation therapy,and acupressure therapy in an effort to stop smoking.Results:showed significant results in the reduction of high blood pressure before being given an intervention was TD:200/100 mmHg and after being given the intervention obtained TD:140/80 mmHg and decreased pain intensity in hypertensive patients using relaxation therapy,as well as a decrease in the number of cigarettes smoked with acupressure therapy for 1 week.Conclusion:The application of complementary therapy carried out showed improvement in elderly patients suffering from hypertension and smoking behaviour,therefore,the application of evidence based nursing in providing nursing care is recommended.Suggestion:Complementary Nursing Case Study this is expended to be a reference material to improve health services and provide an overview in carrying out complementary nursing care to families,especially an elderly with comprehensive cases of hypertension(bio,psycho,social and spiritual).展开更多
Objective: To investigate the association of Glu298Asp polymorphism of theeNOS gene with essential hypertension in elderly people. Methods: Ninety-five cases of essentialhypertension were randomly chosen from outpatie...Objective: To investigate the association of Glu298Asp polymorphism of theeNOS gene with essential hypertension in elderly people. Methods: Ninety-five cases of essentialhypertension were randomly chosen from outpatients and inpatients as the study group, and an equalnumber of sexes, age-matched healthy people as the control group. Their height, weight and bloodpressure were recorded and their fasting plasma lipid concentrations were measured. Glu298Asppolymorphism of the eNOS gene was measured using the methods of PCR and RFLP. Results: Theconstituent ratio of Genotype Glu/Asp in the study group (26.3%) was higher than that in the controlgroup (12.6%, x^2 = 5. 67, P<0.05), the allelic frequency of 298Asp in the study group (13.2%) wassignificantly higher than that in the control group (6.3%, x^2 = 5.06, P<0.05). Conclusion: Glu298Asp variant of the eNOS gene may be an independent predictor in essential hypertension.展开更多
Hypertension is a leading cause of mortality and morbidity around the world and,prevalence of hypertension is increasing with aging.Hypertension in the elderly is associated with increased occurrence rates of sodium s...Hypertension is a leading cause of mortality and morbidity around the world and,prevalence of hypertension is increasing with aging.Hypertension in the elderly is associated with increased occurrence rates of sodium sensitivity,isolated systolic hypertension,and ＇white coat effect＇.Arterial stiffness and endothelial dysfunction also increase with age.These factors should be considered in selecting antihypertensive therapy.The prime objective of this therapy is to prevent stroke.The fmdings of controlled trials show that there should be no cut-off age for treatment.A holistic program for controlling cardiovascular risks should be fully discussed with the patient,including evaluation to exclude underlying causes of secondary hypertension,and implementation of lifestyle measures.The choice of antihypertensive drug therapy is influenced by concomitant disease and previous medication history,but will typically include a thiazide diuretic as the first-line agent;to this will be added an angiotensin inhibitor and/or a calcium channel blocker.Beta blockers are not generally recommended,in part because they do not combat the effects of increased arterial stiffness.The hypertension-hypoten-sion syndrome requires case-specific management.Drug-resistant hypertension is important to differentiate from faulty compliance with medication.Patients resistant to the third-line drug therapy may benefit from treatment with extended-release isosorbide mononitrate.A trial of spironolactone may also be worthwhile.展开更多
Background: Among Chinese adults aged 35 - 75 years, nearly half have hypertension and the prevalence of hypertension is increased with age. But older patients with high systolic pressure and high pulse pressure could...Background: Among Chinese adults aged 35 - 75 years, nearly half have hypertension and the prevalence of hypertension is increased with age. But older patients with high systolic pressure and high pulse pressure could not be cured, and will have greater cardiovascular morbidity. This study aims to evaluate the effectiveness of general practitioners (GP) management for Chinese elderly hypertension, and explore reasonable and effective blood pressure management pattern. Methods: We searched the published literature for randomized controlled trials designed to improve blood pressure with community care management delivered by general practitioners or nurses, compared with usual care. Major outcome measures were systolic and diastolic blood pressure;the percentage of patients whose blood pressures are under control with community care management and Revman 5.3 was used in this study. Results: Pooled data from all 13 researches showed a lower outcome diastolic blood pressure (SMD = −0.95, 95% CI (−1.23, −0.67)) and systolic blood pressure (SMD = −1.17, 95% CI (−1.52, −0.81)) respectively in favor of community management. Pooled data from all 11 researches showed a higher percentage of patients with blood pressure under control in favor of community management (OR = 3.85, 95% CI (1.58, 9.37)) and the difference between treatment group and control group on blood pressure control ratio had statistical significance (Z = 2.97, P Conclusions: General practitioners’ management in Chinese elderly hypertension is effective, and complies with the advanced hypertension management guidelines. The multi-patterns are supposed to adopt community blood pressure monitoring and team-based general practitioners.展开更多
1 Introduction Pulmonary hypertension （PH） is a haemodynamic and pathophysiological condition defined as increase in mean pulmonary arterial pressure≥ 25 mmHg at rest as assessed by right heart catheterization （...1 Introduction Pulmonary hypertension （PH） is a haemodynamic and pathophysiological condition defined as increase in mean pulmonary arterial pressure≥ 25 mmHg at rest as assessed by right heart catheterization （RHC）.展开更多
Objective:To determine the effects of the Self-Management Training Program on self-management behavior and blood pressure(BP)levels among elderly people with hypertension(HT).Methods:This study was based on a quasi-ex...Objective:To determine the effects of the Self-Management Training Program on self-management behavior and blood pressure(BP)levels among elderly people with hypertension(HT).Methods:This study was based on a quasi-experimental design using sampling groups composed of elderly residents of Pathum Thani Province with HT.Simple random sampling was applied to two sampling groups,an experimental group and a control group.However,the experimental group had been on the Self-Management Training Program based on the Creer concept.The Program’s contents included small-group health-education sessions and the patients’manual,Self-Management Training Skills for Self-Management Behavior.Small group discussions were held for self-reflection,to stimulate follow-up for self-management behavior training during home visits.The Self-Management Training Program was compared with programs involving the more usual care.Data were collected using the Self-Management Behavior for Hypertension Control Questionnaire and BP assessment tests.Data were analyzed using a descriptive statistic,chi-square test,pair t-test,repeated-measures Analysis of Variance(ANOVA),and repeated-measures Analysis Covariance(ANCOVA).Results:It was found that at 13 weeks after entering the program,the experimental group demonstrated a significantly lower systolic and diastolic BP with a baseline statistical significance(P<0.005),and that at the 4th week and the 13th week,there was a decrease in BP in the experimental group.The experimental group also had above-baseline self-management behavior scores that were higher than in the control group(P<0.01).Conclusions:Results from this study show that the Self-Management Program was useful for BP control and promoted sustainable self-management behavior.展开更多
文摘Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patients'blood pressure,they were divided into Group A,Group B and Group C,and all the data of hypertension patients in this study were collected,including age,gender,BMI,smoking,drinking,basic diseases(diabetes,cerebrovascular disease,hyperlipidemia,etc.),fasting blood glucose,ambulatory blood pressure(24-hour mean systolic pressure,24-hour mean diastolic pressure,daytime mean systolic pressure and daytime mean diastolic pressure).Results:There were significant differences in mean systolic blood pressure and mean diastolic blood pressure at night among Group A,Group B and Group C(P<0.05).Age,hyperlipidemia and fasting blood glucose were risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium was a protective factor for circadian rhythm abnormality(P<0.05).Conclusion:Age,hyperlipidemia and fasting blood glucose are risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium is a protective factor for circadian rhythm abnormality(P<0.05).
文摘Introduction: In Guinea, there is few data on dietary practices socio-economic and clinical characteristics of elderly diabetics and hypertensives. Methods: This was a descriptive cross-sectional study of people aged 60 years and over, seen in consultation or hospitalised in Conakry University hospitals during the period from 5 September to 15 December 2023 inclusively. Results: Among the 320 subjects included in the study, there were more men (50.6%). The average age was 67 ± 7.69 years;53.43% had hypertension and 46.57% had diabetes. Sex was significantly associated with diabetes (p = 0.035). Women in the study were more affected by diabetes (55.7%), 64.4% of diabetic subjects were married and more than 64% of them had dependent children. 26.2% of diabetics were not employed;85.9% had an income;34.9% had an income of less than one million Guinean francs per month and 74.5% of them had 3 meals a day. Physical activity, 24-hour recall for lunch (p Conclusion: Effective management of diabetes and hypertension in the elderly should necessarily involve nutrition education in hospitals.
基金2022 Key Project of Guangxi Vocational Education Teaching Reform Research,“Research and Practice on the Joint Construction and Sharing of Ideological and Political Resource Library for Medical and Health Courses under the Background of High-Quality Development”(Project Number:GXZZJG2022A035)。
文摘Objective:To explore the effects of health education and chronic disease management nursing in elderly community patients with hypertension,in order to provide scientific evidence for improving the health management level of these patients.Methods:Sixty-four elderly hypertension patients treated at this hospital between March 2022 and March 2024 were selected and randomly divided into two groups,with 32 patients in each group.One group received conventional management,designated as the control group,while the other group received a combined management strategy involving health education and chronic disease management,designated as the experimental group.The study compared the management outcomes of the two groups to evaluate the value of the combined management approach in elderly hypertensive patients in the community.Results:The study found that the experimental group showed significantly lower systolic blood pressure(SBP),diastolic blood pressure(DBP),and scores on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)compared to the control group,with statistically significant differences(P<0.05).Additionally,the experimental group demonstrated significantly higher scores in disease cognition levels regarding awareness of normal blood pressure ranges,prevention of complications,identification of high-risk factors,and healthy lifestyle practices,with statistically significant differences(P<0.05).Moreover,the experimental group showed significantly better rates of self-management behaviors,such as quitting smoking and alcohol,self-monitoring of blood pressure,dietary control,regular medication adherence,and consistent exercise,compared to the control group,with statistically significant differences(P<0.05).Conclusion:This study indicates that a combined management model integrating health education and chronic disease management effectively improves the emotional state of elderly hypertensive patients in the community,significantly enhances their disease cognition levels,and boosts their self-management abilities.Furthermore,this model can effectively lower patients’blood pressure,thereby achieving better health management outcomes for elderly hypertensive patients in the community.
文摘Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.
文摘The elderly are the most rapidly growing population group in the world.Data collected over a 30-year period have demonstrated the increasing prevalence of hypertension with age.The risk of coronary artery disease,stroke,congestive heart disease,chronic kidney insufficiency and dementia is also increased in this subgroup of hypertensives.Hypertension in the elderly patients represents a management dilemma to cardiovascular specialists and other practioners.During the last years and before the findings of the Systolic Hypertension in Europe Trial were published,the general medical opinion considered not to decrease blood pressure values similarly to other younger patients,in order to avoid possible ischemic events and poor oxygenation of the organs(brain,heart,kidney).The aim of this review article is to highlight the importance of treating hypertension in aged population in order to improve their quality of life and lower the incidence of the cardiovascular complications.
文摘Background Little is known about the prevalence oforthostatic hypertension （OHT） and its effect on long-term mortality in the eld- erly. We evaluated the prevalence of OHT and its effect on mortality in hospitalized elderly patients. Methods Out of 1852 patients admit- ted between 31/12/1999 and 31/12/2000 to an acute geriatric ward, 474 patients （48% males） with a mean age of 81.5 ±6.8 years were en- rolled in this study. Blood pressure （BP） was measured three times during the day in a supine and standing position. Patients with at least one increase in systolic or diastolic BP levels upon standing were diagnosed with OHT. Medical history, physical examination and laboratory parameters were retrieved from the medical records. Mortality data until 18th June 2014 were retrieved from the computerized system of the Ministry of the Interior. Results Four hundred and seven patients （86%） were diagnosed with OHT. Those without OHT had a lowerbody mass index and were more likely males, smokers, had a higher rate of Parkinson＇s disease and less congestive heart failure compared with those with OHT. Patients with OHT had a better survival rate than those without OHT （P = 0.024）. Hazard ratios （HRs） for mortality in those with OHT adjusted to age and multiple risk factors were： 0.67 [95% confidence interval （CI）： 0.51-0.87] and 0.73 （95% CI： 0.55-0.97）, respectively; a similar tendency was noticed in a sensitivity analysis by gender. Conclusion Hospitalized elderly patients with OHT had a better survival rate than those without OHT.
文摘AIM:To present a dedicated series of transjugular intrahepatic porto-systemic shunts(TIPS) in the elderly since data is sparse on this population group.METHODS:A retrospective review was performed of patients at least 65 years of age who underwent TIPS at our institutions between 1997 and 2010.Twentyfive patients were referred for TIPS.We deemed that 2 patients were not considered appropriate candidates due to their markedly advanced liver disease.Of the 23 patients suitable for TIPS,the indications for TIPS placement was portal hypertension complicated by refractory ascites alone(n = 9),hepatic hydrothorax alone(n = 2),refractory ascites and hydrothorax(n = 1),gastrointestinal bleeding alone(n = 8),gastrointestinal bleeding and ascites(n = 3).RESULTS:Of these 23 attempted TIPS procedure patients,21 patients had technically successful TIPS procedures.A total of 29 out of 32 TIPS procedures including revisions were successful in 21 patients with a mean age of 72.1 years(range 65-82 years).Three of the procedures were unsuccessful attempts at TIPS and 8 procedures were successful revisions of our existing TIPS.Sixteen of 21 patients who underwent successful TIPS(excluding 5 patients lost to follow-up) were followed for a mean of 14.7 mo.Ascites and/or hydrothorax was controlled following technically successful procedures in 12 of 13 patients.Bleeding was controlled following technically successful procedures in 10 out of 11 patients.CONCLUSION:We have demonstrated that TIPS is an effective procedure to control refractory complications of portal hypertension in elderly patients.
文摘Backgrounds Pulmonary arterial hypertension （PAH） was previously considered an illness that affects mostly the young, but now it is also increasingly recognized in the elderly. The aim of this study was to compare the features of elderly versus younger patients diagnosed with PAH, and to define the prognostic factors which affect their long-term survival. Methods In this prospective, single center study, the clinical, echocardiographic, hemodynamic characteristics, and the outcomes of younger （18-65 years） and elderly （〉 65 years） patients with definitive diagnosis of precapillary PAIl were compared. Results A total of 119 patients were analyzed in this study; 43 were elderly （mean age： 71.5 ± 5.5 years）, while 76 were non-elderly （mean age 44.5 ±15.2 years）. During the mean follow-up duration of 26.8 ±25.0 months, 43 deaths occurred, 17 of which were among the elderly group, with 28 among non-elderly group. Comparison of baseline parameters showed that 6 min walking distance, hemoglobin levels, pulmonary artery pressures and pulmonary vascular resistance were significantly lower; and estimated glomerular filtration rate, body mass index, E/e＇ and pulmonary capillary wedge pressure were significantly higher in the elderly group than in the younger group. Survival analysis demonstrated that the independent predictors of death were tricuspid plane annular systolic excursion （TAPSE; HR： 1.272, 95% CI： 1.079-1.499, P = 0.004） and uric acid （HR： 1.291, 95% CI： 1.042-1.600, P = 0.019） in the elderly group. In contrast, in the non-elderly group, higher brain natriuretic peptide （HR： 1.002, 95% CI： 1.001-1.004, P 〈 0.001） and higher right atrial pressure （HR： 1.128, 95% CI： 1.026-1.241, P = 0.013） values were the only parameters associated with mortality. Conclusions Our data suggest that elderly PAH patients have a unique clinical and hemodynamic profile, with totally different prognostic markers compared to younger PAH patients.
文摘Objective The aim of the study is to investigate the effects of psychosocial factors on the treatment of elderly patients with hypertension. Methods Atotalof 260 elderly Chinese patients with hypertension were treated with benazepril alone or benazepril combined with amlodipine for 8 weeks. The target blood pressure (BP) (both <140 mmHg systolic, SBP, and <90 mmHg diastolic, DBP) was achieved in 180 patients, who were then assigned to the well-controlled BP group;the rest were placed in the modestly controlled BP group. The psychosocial factors present in both groups were assessed by the Hamilton depression scale, Hamilton anxiety scale, life event scale and social support evaluation list before and after anti-hypertensive treatment. Results There were no significant differences in gender, mean age, hist ory of hypertension, education and smoking habit, or in SBP and DBP between the groups before treatment. Significant differences were also not found in all psychosocial factors before and after treatment in the patients. However, significant differences were found between the groups with respect to post-treatment SBP and marital status. The patients with modestly controlled BP had significantly higher scores, as well as incidents, on the depressive, anxiety, and stressful life event scales than those with well-controlled BP. The patients with well-controlled BP had significantly higher scores in tangible support, subjective support, and social support compared to the patients with modestly controlled BP. Logistic regression analysis showed the independent contribution of psychosocial factors in reaching the goal of lowering BP at treatment endpoint in these hypertensive patients. Conclusions The results suggest that psychosocial factors stand as a main barrier to achieving the BP-lowering target in the management of elderly Chinese patients with hypertension.(J Geriatr Cardiol 2007;4:202-207.)
文摘Hypertension is one of the most important risk factors for heart diseases today. The effect of hypertension in the elderly is higher than other age groups and it may lead to changes in their quality of life. By the increase of age, the amount of self-care behaviors of patients with hypertension decreased. Therefore, control and self-care behaviors are so important. This study has been conducted to study self-regulation behaviors and Associated Factors in elderly patients with hypertension. This study was a cross sectional, descriptive analytic study, which was conducted using multistage sampling on the elderly 60 years and above with hypertension. The sample size was calculated 365 and the final sample size of 380 people was considered by possible losses. The instruments include of demographic and self-regulatory behaviors questionnaire. The results showed that self-regulation of behavior was 42.3% of the total score. In terms of quality, only 7.4% of the elderly had good behavior, 46.6% of poor performance, and the rest were mediocre performance. Age (p = 0.03), gender (p = 0.02), education (p = 0.001), income level (p = 0.03) and marital status (p = 0.001) significantly associated with behaviors of self-regulation. The results generally indicate unfavorable self-regulation of elderly patients with hypertension. Some variables such as gender, age, marital status, education and income levels were associated with these behaviors. So paying attention to the education of the elderly in care centers is essential.
文摘In recent times, the prevalence of pulmonary arterial hypertension creased prevalence of hypertension, diabetes, obesity, arterial stiffness, （PAH） is more commonly seen among elderly populations. The inas well as diastolic dysfunction, may cause endothelial dysfunction and affect pulmonary vasculature. Furthermore, older patients have certain differences in clinical characteristics and outcomes. In this article the special characteristics of aging in PAH patients have been reviewed, while the risk predictors of elderly patients are also discussed.
文摘Objective To compare knowledge about hypertension between elderly Chinese urban patients with preferences for either traditional Chinese medicine (TCM) or Western medicine (WM). Methods Elderly (≥ 65 years old) patients with hypertension who prefer TCM treatment (n=112) or WM (n=126) were questioned about hypertension. Their answers were compared. Results Only 32.6% of participants correctly identified hypertension as a main risk factor of coronary heart disease and stroke, 22.3% of patients answered that the main purpose of hypertension control was preventing cardiovascular disease. Other major reasons for these patients to seek medical treatment for their hypertension included: persuasion by physicians or their family members (21.6%), alleviating symptoms such as headache and dizziness (16.8%), lowering blood pressure without knowing specific reason (12.4%). The predictors for poor knowledge of hypertension were similar irrespective of preference for WM or TCM treatment, and included those with lower levels of education and older age. Television and newspaper (46.8%) were the most frequent sources of hypertension information for both groups. Among those who preferred TCM treatment, "TCM has fewer side effects than WM" and"TCM cures disease while WM only alleviates symptoms" were common beliefs held. Conclusion This study shows that knowledge of hypertension is similar among Chinese urban patients with preferences for either WM or TCM treatment and that misunderstandings about hypertension are common among the elderly patients. In order to control hypertension effectively, public health education is necessary. This should target those with a lower level of education and older age.
文摘Recent reports from pulmonary arterial hypertension （PAH） registries suggest that the mean age at diagnosis is increasing in a growing proportion of elderly patients. The combination of several reasons such as aging popula- tion, increase in life expectancy, growing PAH awareness of physicians and patients, and availability of more treatment options could explain the changing picture of PAH. PAH should be considered as an emerging entity in the elderly.
文摘Background Elevated resting heart rate and hypertension independently increase the risk of mortality. However, their combined ef- fect on mortality in stages of hypertension according to updated clinical guidelines among dderly population is unclear. Methods We fol- lowed a cohort of 6100 residents （2600 males and 3500 females） of Kangwha County, Korea, ranging from 55 to 99 year-olds as of March 1985, for all-cause and cardiovascular mortality for 20.8 years until December 31, 2005. Mortality data were collected through telephone calls and visits （to 1991）, and were confirmed by death record matching with the National Statistical Office （1992-2005）. Hazard ratios were calculated for all-cause and cardiovascular mortality by resting heart rate and hypertension defined by Eighth Joint National Committee crite- ria using the Cox proportional hazard model after controlling for confounding factors. Results The hazard ratios associated with resting heart rate 〉 80 beats/min were higher in hypertensive men compared with normotensives with heart rate of 61-79 beats/rain, with hazard ratios values of 1.43 （95% CI： 1.00-1.92） on all-cause mortality for prehypertension, 3.01 （95% CI： 1.07-8.28） on cardiovascular mortality for prehypertension, and 8.34 （95% CI： 2.52-28.19） for stage 2 hypertension. Increased risk （HR： 3.54, 95% CI： 1.16-9.21） was observed among those with both a resting heart rate 〉 80 beats/rain and prehypertension on cardiovascular mortality in women. Conclusions Indi- viduals with coexisting elevated resting heart rate and hypertension, even in prehypertension, have a greater risk for all-cause and cardiovas- cular mortality compared to those with elevated resting heart rate or hypertension alone. These findings suggest that elevated resting heart rate should not be regarded as a less serious risk factor in elderly hypertensive patients.
文摘Background:An elderly was closed to some medical problem,especially hypertension.Problems that occur in elderly patients with hypertension not only involve the patient itself but also involve the family as the closest person to the patient.One important aspect of family nursing is the family itself.To achieve good treatment outcomes,implementation of evidence-based nursing is needed.The purpose of this study is to present the implementation of evidence-based nursing to an eldelry in a family bu using coconut water to reduce high blood pressure and progressive muscle relaxation therapy to reduce pain intensity in hypertensive patients,as well as acupressure therapy in stopping smoking that is applied 1 week each other.Method:In the implementation,complementary therapy is applied to hypertensive patients by given young coconut water and progressive muscle relaxation therapy,and acupressure therapy in an effort to stop smoking.Results:showed significant results in the reduction of high blood pressure before being given an intervention was TD:200/100 mmHg and after being given the intervention obtained TD:140/80 mmHg and decreased pain intensity in hypertensive patients using relaxation therapy,as well as a decrease in the number of cigarettes smoked with acupressure therapy for 1 week.Conclusion:The application of complementary therapy carried out showed improvement in elderly patients suffering from hypertension and smoking behaviour,therefore,the application of evidence based nursing in providing nursing care is recommended.Suggestion:Complementary Nursing Case Study this is expended to be a reference material to improve health services and provide an overview in carrying out complementary nursing care to families,especially an elderly with comprehensive cases of hypertension(bio,psycho,social and spiritual).
基金Supported by the National Science of Foundation of Jiangsu Province(BK 2001162)
文摘Objective: To investigate the association of Glu298Asp polymorphism of theeNOS gene with essential hypertension in elderly people. Methods: Ninety-five cases of essentialhypertension were randomly chosen from outpatients and inpatients as the study group, and an equalnumber of sexes, age-matched healthy people as the control group. Their height, weight and bloodpressure were recorded and their fasting plasma lipid concentrations were measured. Glu298Asppolymorphism of the eNOS gene was measured using the methods of PCR and RFLP. Results: Theconstituent ratio of Genotype Glu/Asp in the study group (26.3%) was higher than that in the controlgroup (12.6%, x^2 = 5. 67, P<0.05), the allelic frequency of 298Asp in the study group (13.2%) wassignificantly higher than that in the control group (6.3%, x^2 = 5.06, P<0.05). Conclusion: Glu298Asp variant of the eNOS gene may be an independent predictor in essential hypertension.
文摘Hypertension is a leading cause of mortality and morbidity around the world and,prevalence of hypertension is increasing with aging.Hypertension in the elderly is associated with increased occurrence rates of sodium sensitivity,isolated systolic hypertension,and ＇white coat effect＇.Arterial stiffness and endothelial dysfunction also increase with age.These factors should be considered in selecting antihypertensive therapy.The prime objective of this therapy is to prevent stroke.The fmdings of controlled trials show that there should be no cut-off age for treatment.A holistic program for controlling cardiovascular risks should be fully discussed with the patient,including evaluation to exclude underlying causes of secondary hypertension,and implementation of lifestyle measures.The choice of antihypertensive drug therapy is influenced by concomitant disease and previous medication history,but will typically include a thiazide diuretic as the first-line agent;to this will be added an angiotensin inhibitor and/or a calcium channel blocker.Beta blockers are not generally recommended,in part because they do not combat the effects of increased arterial stiffness.The hypertension-hypoten-sion syndrome requires case-specific management.Drug-resistant hypertension is important to differentiate from faulty compliance with medication.Patients resistant to the third-line drug therapy may benefit from treatment with extended-release isosorbide mononitrate.A trial of spironolactone may also be worthwhile.
文摘Background: Among Chinese adults aged 35 - 75 years, nearly half have hypertension and the prevalence of hypertension is increased with age. But older patients with high systolic pressure and high pulse pressure could not be cured, and will have greater cardiovascular morbidity. This study aims to evaluate the effectiveness of general practitioners (GP) management for Chinese elderly hypertension, and explore reasonable and effective blood pressure management pattern. Methods: We searched the published literature for randomized controlled trials designed to improve blood pressure with community care management delivered by general practitioners or nurses, compared with usual care. Major outcome measures were systolic and diastolic blood pressure;the percentage of patients whose blood pressures are under control with community care management and Revman 5.3 was used in this study. Results: Pooled data from all 13 researches showed a lower outcome diastolic blood pressure (SMD = −0.95, 95% CI (−1.23, −0.67)) and systolic blood pressure (SMD = −1.17, 95% CI (−1.52, −0.81)) respectively in favor of community management. Pooled data from all 11 researches showed a higher percentage of patients with blood pressure under control in favor of community management (OR = 3.85, 95% CI (1.58, 9.37)) and the difference between treatment group and control group on blood pressure control ratio had statistical significance (Z = 2.97, P Conclusions: General practitioners’ management in Chinese elderly hypertension is effective, and complies with the advanced hypertension management guidelines. The multi-patterns are supposed to adopt community blood pressure monitoring and team-based general practitioners.
文摘1 Introduction Pulmonary hypertension （PH） is a haemodynamic and pathophysiological condition defined as increase in mean pulmonary arterial pressure≥ 25 mmHg at rest as assessed by right heart catheterization （RHC）.
文摘Objective:To determine the effects of the Self-Management Training Program on self-management behavior and blood pressure(BP)levels among elderly people with hypertension(HT).Methods:This study was based on a quasi-experimental design using sampling groups composed of elderly residents of Pathum Thani Province with HT.Simple random sampling was applied to two sampling groups,an experimental group and a control group.However,the experimental group had been on the Self-Management Training Program based on the Creer concept.The Program’s contents included small-group health-education sessions and the patients’manual,Self-Management Training Skills for Self-Management Behavior.Small group discussions were held for self-reflection,to stimulate follow-up for self-management behavior training during home visits.The Self-Management Training Program was compared with programs involving the more usual care.Data were collected using the Self-Management Behavior for Hypertension Control Questionnaire and BP assessment tests.Data were analyzed using a descriptive statistic,chi-square test,pair t-test,repeated-measures Analysis of Variance(ANOVA),and repeated-measures Analysis Covariance(ANCOVA).Results:It was found that at 13 weeks after entering the program,the experimental group demonstrated a significantly lower systolic and diastolic BP with a baseline statistical significance(P<0.005),and that at the 4th week and the 13th week,there was a decrease in BP in the experimental group.The experimental group also had above-baseline self-management behavior scores that were higher than in the control group(P<0.01).Conclusions:Results from this study show that the Self-Management Program was useful for BP control and promoted sustainable self-management behavior.
